We are proud to announce that Hebrew School will be under the talented direction of Morah Shaina Andrusier. Feel free to contact her at 954-252-1770. We are looking forward to a great year in Hebrew School!

FAMILY INFORMATION:

Family Name:

Home Phone:

Address:

City, State, Zip:

Mother's Information

Name:

Hebrew Name:

Birthday:

Address: (if different)

Home Phone: (if different)

Cell:

Work:

Email:

Father's Information

Name:

Hebrew Name:

Birthday:

Address: (if different)

Home Phone: (if different)

Cell:

Work:

Email:

Marital Status:

Child resides with:

If other, please specify:

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STUDENT INFORMATION - CHILD 1

Name:

Hebrew Name:

Date of Birth:

City of Birth:

Time of Birth:

AM PM

School:

Grade in Sept. 2018:

STUDENT INFORMATION - CHILD 2

Name:

Hebrew Name:

Date of Birth:

City of Birth:

Time of Birth:

AM PM

School:

Grade in Sept. 2018:

GENERAL INFORMATION

Is the natural mother of the child Jewish? YesNo

Is the mother's mother Jewish? Yes No

Is the natural father of the child Jewish? Yes No

Is the father's mother Jewish? Yes No

Have there been any conversions or adoptions in the family history? ﻿

Has your child(ren) attended Hebrew School before?

If yes, where and for how long?

Does your child(ren) have any learning disablities with general studies? Please specify.

Special Instructions (allergies, etc):

Emergency Contact (Besides Parent):

Name:

Phone number:

Persons authorized to pick up my child(ren):

What are some of the goals you hope your child will achieve through attending the Chabad Hebrew School?

CHS is proud to offer a $100 tuition credit to any current family that refers a new family who then enrolls their child/ren in Chabad Hebrew School! There is no limit on the amount of tuition credits you may earn and you can potentially cover your entire tuition cost through this program. Tuition Credits are awarded per new family that enrolls.

Help yourself while you help your school grow!

Membership

Membership entitles you to High Holiday seats and various discounts throughout the year. Membership is not required for participation in Chabad programs.

Platinum Members $3600

Gold Members$2400

Silver Members$1800

Family Members$1200

Scholarship Information

At Chabad, no child will be turned away for lack of funds. Call our office to inquire about the scholarship qualifications and the application process. A scholarship application must be completed for review by the Scholarship Board.Please note: Scholarship and payment plan agreements must be signed prior to your child beginning Hebrew School.

Payment Plans

1 Check / Credit Card* payment in full (due before the first day of Hebrew School)

Please divide my Check payment into installments, for deposit on the 15th of each month. All post-dated checks must be submitted with registration.

Please divide my Credit Card* into installments to be charged on the 15th of each month.

Card Number: Exp: Security Code:

Zip Code:

*A service charge of 3.5% will be added to all tuition and fee payments made by credit card.

I would like to assist a child who cannot afford Hebrew School Education.

Admissions: This signed registration form along with full payment or completed and approved payment plan must be submitted to the school office before any child will be permitted to attend classes. Registration and enrollment is only complete after payment plan approval and registration fees are received.Refund Policy: Refunds for children withdrawing from school before the end of the school year will be pro-rated up to February 1st provided that the school office is given 30 days written notice. Tuition refunds will not be granted to children withdrawing from school after February 1. Registration and book fees are non-refundable. There are no refunds or credits for days missed due to illness, holidays, or family vacations.

Emergency plan: I authorize any adult acting on behalf of Chabad Hebrew School to hospitalize or secure treatment for my child, I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Chabad Hebrew School personnel will try, but are not required, to communicate with me/us prior to such treatment.

Miscellaneous: I allow my child to be photographed while participating in Hebrew School activities and for these photographs to be used in the marketing of Chabad activities. I understand that all liability and costs resulting from damage to property and/or personal injury caused or attributable to my child(ren)will be my responsibility and I agree to fully indemnify Chabad Lubavitch of Southwest Broward, Inc. and Chabad Hebrew School and its associates, teachers and agents harmless therefrom. I authorize my child(ren) to participate in trips conducted by Chabad Hebrew School.

I certify that I am the parent or legal guardian of the above listed child(ren), that I have read and understand the full agreement as published online at ChabadSWB.com, that I agree to pay full amount due and that I agree to all policies as set forth by Chabad Hebrew School.